From Silos to Scaffolding: Engaging and Effective Social Work Practice

In this final article of the special issue Beyond the Manual: Using Data and Judgment in Clinical Social Work Practice, we extend the discussion regarding the use of data and judgment. We discuss the multiple sources of data used in practice, including research evidence, client perspectives and experience, moment-by-moment process observation, and client feedback regarding progress towards specific, desired outcomes. We move beyond current debates purporting one framework over another to propose a synthesizing framework that situates evidence-based practice, empirically supported interventions and common elements/mapping and adapting practice within a common factors scaffolding framework. This framework provides a way for social workers to effectively make sound judgments using research and client data within the demands of contemporary practice. The article provides a brief overview of the four practice approaches followed by the proposed scaffolding framework and rationale, and concludes with implications for practice, professional education, and research.     

The persistence of cliques in the post‐communist state. The case of deniability in drug reimbursement policy in Poland

This article explores a key question in political sociology: Can post‐communist policy‐making be described with classical theories of the Western state or do we need a theory of the specificity of the post‐communist state? In so doing, we consider Janine Wedel's clique theory, concerned with informal social actors and processes in post‐communist transition. We conducted a case study of drug reimbursement policy in Poland, using 109 stakeholder interviews, official documents and media coverage. Drawing on ‘sensitizing concepts’ from Wedel's theory, especially the notion of ‘deniability’, we developed an explanation of why Poland's reimbursement policy combined suboptimal outcomes, procedural irregularities with limited accountability of key stakeholders. We argue that deniability was created through four main mechanisms: (1) blurred boundaries between different types of state authority allowing for the dispersion of blame for controversial policy decisions; (2) bridging different sectors by ‘institutional nomads’, who often escaped existing conflicts of interest regulations; (3) institutional nomads’ ‘flexible’ methods of influence premised on managing roles and representations; and (4) coordination of resources and influence by elite cliques monopolizing exclusive policy expertise. Overall, the greatest power over drug reimbursement was often associated with lowest accountability. We suggest, therefore, that the clique theory can be generalized from its home domain of explanation in foreign aid and privatizations to more technologically advanced policies in Poland and other post‐communist countries. This conclusion is not identical, however, with arguing the uniqueness of the post‐communist state. Rather, we show potential for using Wedel's account to analyse policy‐making in Western democracies and indicate scope for its possible integration with the classical theories of the state.     

The Rise and Fall of a Regulator: Adventure Sports in the United Kingdom

Following a tragic accident in 1993 involving the deaths of teenagers while kayaking a new regulatory regime was imposed upon some adventure sports providers in the United Kingdom. In particular, a new regulatory body, the Adventure Activities Licensing Authority (AALA), was established to oversee the sector. Yet in 2010, a government‐sponsored review recommended that AALA be abolished and this recommendation has been quickly accepted by government. This article explores the background to these developments through documentation, interviews with those affected by the AALA regime, and court cases. Evidence reported here, perhaps surprising, is that AALA itself is seen in a very positive light by many, even those it regulates. What may have happened is that AALA became caught up in a wider debate about the place and management of risk in life beyond the workplace, which has been simmering in the United Kingdom for a decade or more, and of which it fell foul. It may also be that adventure sports, because they entail voluntary engagement with high consequence hazards, starkly expose serious questions about the application of conventional, factory‐originated risk assessment approaches to life in general.     

Substance Use and Psychosocial Predictors of High School Dropout in Cape Town, South Africa

The aims of this study were to examine whether use of tobacco, alcohol, and illicit drugs predicts dropout among secondary school students in Cape Town, South Africa. A self-report instrument was administered to 1,470 Grade 8 students. The proportion of students that dropped out of school between the onset of the study and 4 years later was 54.9%. After adjusting for a range of confounders, dropout was significantly predicted by absenteeism, poverty (as assessed by a possession index), and past month cigarette use, but not by past month alcohol use and lifetime illicit drug use. Contrary to findings from developed countries, alcohol and illicit drug use did not predict dropout. It is possible that predictors of dropout documented elsewhere may not be pertinent in developing countries.     

Attitudinal correlates associated with recent alcohol use and episodic heavy drinking among African American youth

African–American students in 7th–12th grades completed the PRIDE survey examining attitudinal correlates associated with recent alcohol use and heavy episodic drinking. Of participants, 13.6% reported using alcohol in the past 30 days and 5.1% reported frequent heavy episodic drinking. Logistic regression analyses indicate that male, in high school and employed increased the odds of engaging in recent use and frequent heavy episodic drinking. Perceived harm and parent/peer disapproval of substance use was negatively associated with use. Results may assist professionals in developing prevention programs for African-American youth.     

Strengthening the Domestic and Family Violence Workforce: Key Questions

ABSTRACT

The significant impact of domestic and family violence in Australia calls for a workforce that is both highly skilled and capable of meeting the demands of complex and challenging jobs. Yet despite the increasingly national visibility of domestic violence, the workers—and work itself—have largely remained invisible. We argue for a shift in conversation, highlighting the need for a workforce approach that is not only strategic but that also applies a theorised lens to domestic and family violence work inclusive of both gender and Indigeneity.

IMPLICATIONS

• The domestic and family violence workforce and workers should be made more visible to better support development in this sector.

• A workforce development strategy is needed to build knowledge about who is doing this work, the nature of the work, workplace structures and cultures, and work environments and conditions.

• The significance of gendered power relations, Indigeneity, high risk, trauma environments, and emotional labour in domestic and family violence work cannot be ignored in development strategies.

     

Sex Differences in Perceived Family Functioning and Family Resources in Hong Kong Families: Implications for Social Work Practice

Although enhancing family functioning has become a rising concern of social workers in Chinese contexts such as Hong Kong, little has been known on perceived family functioning and family resources. To fill in this knowledge gap, this article reports part of the results of a telephone survey conducted in Hong Kong, aiming to identify the sex differences in these two areas. The results of the study have shown that Chinese women perceived better affective involvement, one of the crucial indicators of family functioning, than Chinese men. However, among the different family resources, men rated better physical and mental well-being whereas women's social connection was stronger than men's. Further analysis have shown that the linkage of three family resources (namely stress coping efficacy, time spent with family and income) to perceived family functioning was statistically significant irrespective of genders. Implications of this study for social work practice are discussed at the end of the article.     

Socioeconomic Status and the Increased Prevalence of Autism in California

The prevalence of autism has increased precipitously-roughly 10-fold in the past 40 years-yet no one knows exactly what caused this dramatic rise. Using a large and representative dataset that spans the California birth cohorts from 1992 through 2000, we examine individual and community resources associated with the likelihood of an autism diagnosis over time. This allows us to identify key social factors that have contributed to increased autism prevalence. While individual-level factors, such as birth weight and parental education, have had a fairly constant effect on likelihood of diagnosis over time, we find that community-level resources drive increased prevalence. This study suggests that neighborhoods dynamically interact with the people living in them in different ways at different times to shape health outcomes. By treating neighborhoods as dynamic, we can better understand the changing socioeconomic gradient of autism and the increase in prevalence.